title: The normal impact of age and gender on right heart structure and function.
abstract: BACKGROUND
  As the proportion of elderly population increases rapidly, it might be difficult to differentiate physiological changes in cardiac function due to age from the pathophysiological ones. In addition, cardiac function variations with gender are well established. The right ventricular (RV) plays an important role in the overall cardiac function, but reference values varying with age and gender are lacking.
  
  
  METHODS
  We studied 255 healthy individuals from a general population register, mean age of 58 ± 19 (range 22-89) years, 125 were females. We used 2D and M-mode echocardiography to measure RV inflow tract (RVIT) and RV outflow tract (RVOT) dimensions and fractional shortening (fs). Spectral Doppler echocardiography was also used.
  
  
  RESULTS
  We found a modest decrease in RVIT dimensions (P < 0.05), but increase in RVOT dimensions with advancing age (P < 0.05). A small decrease in RVOT fs with age was also found (P < 0.05). Estimated pulmonary pressures and pulmonary vascular resistance increased (P < 0.001) as did RVOT wall thickness (P < 0.001), but RV diastolic function was not altered (P < 0.001) with age. Despite correction for the BSA, males showed larger RVIT dimensions (P < 0.001 for both), but RVOT end-diastolic dimension was larger in females (P < 0.05). RVIT and RVOT fractional shortening were increased in females (P < 0.01 for both).
  
  
  CONCLUSIONS
  In a cohort of normal individuals, age has significant impact on RV structure and function, inlet area falls and outflow tract dimensions increase and fractional shortening also increase in females. In addition, RVOT wall thickness significantly increases and Doppler markers of pulmonary vascular resistance show a consistent rise. The age-related changes should carefully be considered when commenting on normality and when using absolute values.
authors.affiliation: Department of Cardiology, Umeå University, Umeå, Sweden; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Henein
authors.forename: Anders
authors.initials: A
authors.lastname: Waldenström
authors.forename: Stellan
authors.initials: S
authors.lastname: Mörner
authors.forename: Per
authors.initials: P
authors.lastname: Lindqvist
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000502:physiology*; D011652:Pulmonary Circulation / Q000502:physiology; D012016:Reference Values; D012042:Registries; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012737:Sex Factors; D013548:Sweden; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: age; gender; right heart function